This bill requires health insurance coverage for preimplantation genetic testing (PGT) and in vitro fertilization (IVF) for individuals who are not classified as infertile, under specific conditions aimed at preventing serious genetic conditions from being passed on to offspring. It mandates that contracts for hospital service corporations, medical service corporations, and health service corporations for groups with more than 50 persons include coverage for medically necessary expenses related to infertility diagnosis and treatment. The bill outlines the services that must be covered, including IVF, embryo transfer, and various assisted reproductive technologies, while establishing criteria for when coverage can be limited based on the medical history and conditions of the covered individuals.

Additionally, the bill clarifies the definition of "infertility" and specifies that coverage for IVF may be limited to individuals who have exhausted other treatment options, have not exceeded a lifetime limit of four egg retrievals, and are 45 years of age or younger. It allows religious employers to request exclusions from coverage that conflicts with their beliefs and mandates that insurers provide clear written notice of such exclusions. The same copayments, deductibles, and benefit limits that apply to other medical services will also apply to infertility treatments, while excluding coverage for infertility resulting from voluntary sterilization procedures. The act is set to take effect 90 days after enactment and will apply to policies or contracts issued or renewed thereafter.

Statutes affected:
Introduced: 17:48-6, 17:48A-7, 17:48E-35.22, 17B:27-46.1, 26:2J-4.23, 52:14-17.29, 52:14-17.46.6